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https://www.readbyqxmd.com/read/28651302/useful-endoscopic-ultrasonography-parameters-and-a-predictive-model-for-the-recurrence-of-esophageal-varices-and-bleeding-after-variceal-ligation
#1
Soung Won Jeong, Hye Soo Kim, Sang Gyune Kim, Jeong-Ju Yoo, Jae Young Jang, Sae Hwan Lee, Hong Soo Kim, Ji Sung Lee, Young Seok Kim, Boo Sung Kim
Background/Aims: To identify the usefulness of endoscopic ultrasonography with a mini-probe (EUM) and to create a predictive model for esophageal variceal (EV) recurrence and bleeding following esophageal variceal ligation (EVL). Methods: A total of 144 patients who received EUM prior to prophylactic EVL and met the inclusion criteria were enrolled. EUM findings, EV diameter, paraesophageal vein diameter, and the number of perforating veins were assessed. Results: EV recurrence was observed in 42 patients (29...
June 27, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28650867/obesity-and-its-implications-on-oncological-urological-surgery
#2
Mohammad Abufaraj, Andrea Mari, Karim Mansy, Karl-Dietrich Sievert
PURPOSE OF REVIEW: To review and summarize the contemporary knowledge of the implications of obesity on perioperative outcomes in oncological urologic surgeries. RECENT FINDINGS: In men undergoing radical prostatectomy, obesity seems to confer a higher risk of intraoperative bleeding, biochemical recurrence, urinary incontinence, and postoperative erectile dysfunction. The literature was not consistent regarding the benefits of a minimally invasive approach in overweight and obese patients...
June 24, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28650086/systemic-thrombolysis-catheter-directed-thrombolysis-and-anticoagulation-for-intermediate-risk-pulmonary-embolism-a-simulation-modeling-analysis
#3
Christopher Kabrhel, Ayman Ali, Jin Choi, Chin Hur
OBJECTIVES: Decision-making around the use of thrombolysis for patients with intermediate-risk (submassive) PE remains challenging. Studies indicate favorable clinical outcomes with systemic thrombolytics (IV tPA), but the risk of major bleeding and hemorrhagic stroke is a deterrent. Catheter-directed thrombolysis (CDT) may be a preferable strategy, as it has been shown to have a lower risk of bleeding than systemic thrombolysis. However, a three-arm randomized control study comparing IV tPA, CDT, and anticoagulation alone, with long-term follow up, would be costly and is unlikely to be performed...
June 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28649894/comparison-of-all-cause-stroke-and-bleed-specific-healthcare-resource-utilization-among-patients-with-non-valvular-atrial-fibrillation-nvaf-and-newly-treated-with-dabigatran-or-warfarin
#4
Xue Song, Pranav Gandhi, Adrienne M Gilligan, Prachi Arora, Cheng Wang, Caroline Henriques, Stephen Sander, David M Smith
OBJECTIVE: We compared healthcare utilization outcomes and persistence among non-valvular atrial fibrillation (NVAF) patients newly treated with dabigatran or warfarin. METHODS: Using a nationwide, US administrative claims database, a retrospective matched-cohort of newly diagnosed NVAF patients (age≥18 years) treated with dabigatran or warfarin (propensity score matched 1:1) in 01/01/2011-12/31/2013 was evaluated. All-cause, stroke- and bleed-specific per-patient per-month (PPPM) HCRU, incidence rate of hospitalization for stroke or bleed, 30-day readmission, and persistence were reported...
June 26, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28649053/left-atrial-appendage-occlusion-with-the-amplatzer-amulet-device-periprocedural-and-early-clinical-echocardiographic-data-from-a-global-prospective-observational-study
#5
Ulf Landmesser, Boris Schmidt, Jens Erik Nielsen-Kudsk, Simon Cheung Chi Lam, Jai-Wun Park, Giuseppe Tarantini, Ignacio Cruz-Gonzalez, Volker Geist, Paolo Della Bella, Antonio Colombo, Tobias Zeus, Heyder Omran, Christopher Piorkowski, Juha Lund, Claudio Tondo, David Hildick-Smith
AIMS: The global, prospective AMPLATZER Amulet observational study documents real-world periprocedural, transoesophageal echocardiographic (TEE) and clinical outcomes from left atrial appendage occlusion (LAAO) using the AMPLATZER Amulet device. The aim of this report is to describe the periprocedural and early clinical/TEE results from this study. METHODS AND RESULTS: This multicentre prospective real-world registry included 1,088 patients (75±8.5 years, 64.5% male, CHA2DS2-VASc: 4...
June 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28648031/-impact-of-different-antithrombotic-therapy-strategy-on-prognosis-in-coronary-heart-disease-patients-combining-with-atrial-fibrillation-a-meta-analysis
#6
C Yuan, L Zhong, R C Huang
Objective: To evaluate the impact of various anticoagulation antiplatelet therapy strategies on the prognosis of patients with coronary heart disease combining with atrial fibrillation. Methods: Present meta analysis was performed according to search results on English EMBASE database by computer retrieval, Pubmed, the Cochrane Central Register of Controlled Trials, Medline, Chinese CBM database, CNKI database, Wan Fang database, China science and technology papers online electronic databases, manual retrieval for important international conference proceedings up to April 30 2016...
June 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28647660/novel-oral-anticoagulants-in-patients-undergoing-cranial-surgery
#7
Davide Marco Croci, Maria Kamenova, Raphael Guzman, Luigi Mariani, Jehuda Soleman
BACKGROUND: The number of patients treated with NOACS is increasing. Despite growing clinical relevance, guidelines on the perioperative management of neurosurgical patients treated with NOACS are still lacking. OBJECTIVES: The aim of this study was to analyze the occurrence of postoperative bleeding events and factors which might influence bleeding rates of these patients. METHODS: Out of 1353 consecutive patients undergoing cranial neurosurgical procedures 30 patients (2...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28647217/recognition-and-management-of-hemostatic-disorders-in-critically-ill-patients-needing-to-undergo-an-invasive-procedure
#8
REVIEW
Marcella C A Müller, Simon J Stanworth, Michiel Coppens, Nicole P Juffermans
Abnormal laboratory coagulation test results are frequently documented in critically ill patients, and these patients often also need to undergo invasive procedures. Clinicians have an understandable desire to minimize any perceived heightened risk of bleeding complications in those patients who require invasive procedures. In this setting, prophylactic administration of platelets or plasma is commonplace. This review explores the nature of these sequential statements and the degree to which these statements are supported by evidence...
June 15, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28647136/polypectomy-for-the-complete-endoscopic-resection-of-small-colorectal-polyps
#9
Qisheng Zhang, Peng Gao, Bin Han, Jianhua Xu, Yucui Shen
BACKGROUND AND AIMS: Small colorectal polyps are frequently encountered and may be incompletely removed during colonoscopy. The optimal technique for removal of small colorectal polyps is uncertain. The aim of this study was to compare the incomplete resection rate (IRR) using endoscopic mucosal resection (EMR) or cold snare polypectomy (CSP) for the removal of small adenomatous polyps. METHODS: This was a prospective randomized controlled study from a tertiary referral center...
June 21, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28646925/stress-ulcer-prophylaxis-versus-placebo-or-no-prophylaxis-in-adult-hospitalised-acutely-ill-patients-protocol-for-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#10
Søren Marker, Anders Perner, Jørn Wetterslev, Marija Barbateskovic, Janus Christian Jakobsen, Mette Krag, Anders Granholm, Carl Thomas Anthon, Morten Hylander Møller
BACKGROUND: Stress ulcer prophylaxis is considered standard of care in many critically ill patients in the intensive care unit (ICU). However, the quality of evidence supporting this has recently been questioned, and clinical equipoise exists. Whether there is overall benefit or harm of stress ulcer prophylaxis in adult hospitalised acutely ill patients is unknown. Accordingly, we aim to assess patient-important benefits and harms of stress ulcer prophylaxis versus placebo or no treatment in adult hospitalised acutely ill patients with high risk of gastrointestinal bleeding irrespective of hospital setting...
June 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28646562/argininosuccinate-synthase-1-ass1-a-marker-of-unclassified-hepatocellular-adenoma-and-high-bleeding-risk
#11
Elodie Henriet, Aya Abou Hammoud, Jean-William Dupuy, Benjamin Dartigues, Zakaria Ezzoukry, Nathalie Dugot-Senant, Thierry Leste-Lasserre, Nestor Pallares-Lupon, Macha Nikolski, Brigitte Le Bail, Jean-Frédéric Blanc, Charles Balabaud, Paulette Bioulac-Sage, Anne-Aurélie Raymond, Frédéric Saltel
Hepatocellular adenomas (HCA) are rare benign tumors divided into three main subgroups defined by patho-molecular features, HNF1A (H-HCA), mutated β-catenin (b-HCA) and inflammatory (IHCA). In the case of unclassified HCA (UHCA), which are currently identified by default, a high risk of bleeding remains a clinical issue. The objective of this study was to explore UHCA proteome with the aim to identify specific biomarkers. Following dissection of the tumoral (T) and non-tumoral (NT) tissue on formalin-fixed paraffin-embedded (FFPE) from HCA tissue sections using laser capture methodology, we performed mass spectrometry analysis to compare T and NT protein expression levels in HCA, H-HCA, IHCA, b-HCA, UHCA and focal nodular hyperplasia...
June 23, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28645879/risk-for-venous-thromboembolism-recurrence-among-rivaroxaban-treated-patients-who-continued-versus-discontinued-therapy-analyses-among-patients-with-vte
#12
Alok A Khorana, Jeffrey S Berger, Philip S Wells, Roger Seheult, Veronica Ashton, François Laliberté, Concetta Crivera, Dominique Lejeune, Jeff Schein, Peter Wildgoose, Patrick Lefebvre, Scott Kaatz
PURPOSE: The EINSTEIN-Extension trial showed that an extended rivaroxaban treatment significantly reduced the risk for venous thromboembolic (VTE) recurrence. The present study assessed the risk for VTE recurrence and major bleeding associated with extended rivaroxaban treatment in a clinical practice setting among patients with VTE. METHODS: A retrospective study was conducted using claims data from February 2011 to April 2015. It included adult patients who initiated rivaroxaban therapy within 7 days after their first VTE and who continuously used rivaroxaban for at least 3 months (index date: end of initial 3-month treatment)...
June 20, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28645834/left-ventricular-assist-device-therapy-for-destination-therapy-is-less-invasive-surgery-a-safe-alternative
#13
Sebastian V Rojas, Jasmin S Hanke, Murat Avsar, Philipp R Ahrens, Ove Deutschmann, Kirstin A Tümler, Aitor Uribarri, Sara Rojas-Hernández, Pedro L Sánchez, José M González-Santos, Axel Haverich, Jan D Schmitto
INTRODUCTION AND OBJECTIVES: The number of older patients with congestive heart failure has dramatically increased. Because of stagnating cardiac transplantation, there is a need for an alternative therapy, which would solve the problem of insufficient donor organ supply. Left ventricular assist devices (LVADs) have recently become more commonly used as destination therapy (DT). Assuming that older patients show a higher risk-profile for LVAD surgery, it is expected that the increasing use of less invasive surgery (LIS) LVAD implantation will improve postoperative outcomes...
June 20, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28645644/-antiplatelet-agents-and-transfusion
#14
P Gaussem, A-C Martin, T Belleville-Rolland, D Helley, C Bachelot-Loza, A Godier
Antiplatelet agents are at risk for bleeding complications, the management of which differs depending on the clinical situation and on the antiplatelet agent itself. Neutralization of antiplatelets is sometimes necessary, most often leading to platelet transfusion, although the benefit of this strategy is poorly documented. In addition, if platelet transfusion corrects the platelet inhibition induced by aspirin and probably by clopidogrel and prasugrel, it does not neutralize ticagrelor, as a consequence of its pharmacological properties...
June 20, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28645473/efficacy-and-safety-of-rivaroxaban-versus-warfarin-in-patients-taking-nondihydropyridine-calcium-channel-blockers-for-atrial-fibrillation-from-the-rocket-af-trial
#15
Jeffrey B Washam, Anne S Hellkamp, Yuliya Lokhnygina, Jonathan P Piccini, Scott D Berkowitz, Christopher C Nessel, Richard C Becker, Günter Breithardt, Keith A A Fox, Jonathan L Halperin, Graeme J Hankey, Kenneth W Mahaffey, Daniel E Singer, Manesh R Patel
Non-dihydropyridine calcium channel blockers (non-DHP CCBs) possess combined P-glycoprotein and moderate CYP3A4 inhibition, which may lead to increased exposure of medications that are substrates for these metabolic pathways, such as rivaroxaban. We evaluated the use and outcomes of non-DHP CCBs in patients with atrial fibrillation (AF) in Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF)...
May 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28645443/once-or-twice-daily-non-vitamin-k-antagonist-oral-anticoagulants-in-asian-patients-with-atrial-fibrillation-a%C3%A2-meta-analysis-of-randomized-controlled-trials
#16
Kang-Ling Wang, Chun-Chih Chiu, Doreen Su-Yin Tan, Chun-Yi Lin, En-Yu Lai, Shinya Goto, Robert P Giugliano, Chern-En Chiang
BACKGROUND/PURPOSE: Non-vitamin K antagonist oral anticoagulants (NOACs) have a half-life of around 12 h. We aimed to clarify if there was any effect modification by dosing (once- or twice-daily) regimens in Asian patients. METHODS: Phase III randomized controlled trials of NOACs compared with warfarin in Asian patients with atrial fibrillation (AF) were identified and extracted from PubMed, CENTRAL, and CINAHL databases through November 2016. Outcomes were pooled by dosing regimens with the Mantel-Haenszel fixed-effects model...
June 20, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28645422/form-of-presentation-natural-history-and-course-of-postoperative-venous-thromboembolism-in-patients-operated-on-for-pelvic-and-abdominal-cancer-analysis-of-the-riete-registry
#17
Ana Belén Bustos Merlo, Juan Ignacio Arcelus Martínez, Jesús Damián Turiño Luque, Beatriz Valero, Aurora Villalobos, Miguel Ángel Aibar, Manuel Monreal Bosch
INTRODUCTION: Venous thromboembolism (VTE) represents a serious complication after oncologic surgery. Recent studies have shown that the risk of VTE persists several weeks after surgery. This study assesses the form of presentation and time course of VTE after abdominal and pelvic cancer surgery. METHODS: Prospective, multicenter, observational study that analyzes data from an international registry (RIETE) that includes consecutive patients with symptomatic VTE...
June 20, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28645246/igmk-paraprotein-from-gammopathy-patient-can-bind-to-cardiolipin-and-interfere-with-coagulation-assay-a-case-report
#18
Xin-Yao Wu, Yu-Feng Yin, Jia-Lin Teng, Li-Wei Zhang, Cheng-de Yang
BACKGROUND: The monoclonal gammopathies are a group of plasma-cell proliferative disorders characterized by the secretion of monoclonal immunoglobulin (M protein or paraprotein). Some rare cases have revealed the specific affinity of paraprotein as autoantibody. Here we report a patient with monoclonal gammopathy of undetermined significance (MGUS) accompanied by a remarkable increase of anticardiolipin antibody (aCL) and an extensively decreased coagulation factor activity, however, without any clinical signs of antiphospholipid syndrome (APS) and bleeding...
June 23, 2017: BMC Immunology
https://www.readbyqxmd.com/read/28644938/preoperative-epoxy-embolization-facilitates-the-safe-and-effective-resection-of-venous-malformations-in-the-hand-and-forearm
#19
Brian P Holly, Yuval A Patel, James Park, Laura M Fayad, E Gene Deune, Sally E Mitchell, Clifford R Weiss
BACKGROUND: The standard of care for treatment of low-flow venous malformations (VMs) is percutaneous sclerotherapy. These lesions are seldom surgically resected, especially if the malformation is in an anatomically difficult location. Percutaneous sclerotherapy is safe and effective. However, the drawbacks to sclerotherapy are the need for repeated treatments and risks of skin ulceration, deep venous thrombosis, scarring/contractures, and nerve damage. Surgical resection can be difficult because of intraoperative bleeding, intraoperative lesional decompression, and difficulty in localization...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644735/fetal-and-neonatal-alloimmune-thrombocytopenia-evidence-based-antenatal-and-postnatal-management-strategies
#20
Dian Winkelhorst, Dick Oepkes, Enrico Lopriore
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a relatively rare but potentially lethal disease, leading to severe bleeding complications in 1 in 11.000 newborns. It is the leading cause of thrombocytopenia in healthy term-born neonates. Areas covered: This review summarizes the antenatal as well as postnatal treatment, thus creating a complete overview of all possible management strategies for FNAIT. Expert commentary: The optimal antenatal therapy in order to prevent bleeding complications in pregnancies complicated by FNAIT is non-invasive treatment with weekly intravenous immunoglobulin (IVIG)...
June 23, 2017: Expert Review of Hematology
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